Paramedics develop an intuition or sixth sense for how a patient is going or a scene is progressing based on their responses of previous experiences, gathered over many years working on the road…

These are some of the clinical words of wisdom and clinical tricks of the trade that often trigger a paramedic’s intuition about a patient deteriorating (even if they don’t realise it), which I have noticed over the years.

1. The patient says “I feel like I’m going to die” – this sounds obvious, but often, junior paramedics don’t realise that when a patient says this, they often mean it and they have their own intuition that they are about to die, so take them very seriously and get them to hospital quick.

2. The patient says “This feels like last time, just before I collapsed” – again, obvious, but important to pick up.

3. When a patient develops repetitive questioning after a head injury. This is a sign that they have had a significant head injury and may deteriorate very quickly.

4. When the injuries don’t match up with the complaint that the patient has made – you must look at who is lying to you, or why the patient doesn’t realise what has happened. This may be a serious trigger or alarm bell for those of you who are treating children or womem who may be being abused.

5. When the patient or friend appears overly keen to get you to follow them – try to slow them down, nothing’s worth rushing too much, and you don’t want to end up being drawn into something dangerous.

6. When a bystander meets you at the scene and tries to get you to go first into an unlit house – some people still try to harm paramedics so that they can get drugs.